- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first** The **Telephonic Nurse Case Manager ** will be a member of the Case Management Team, providing ... approach for case management throughout the continuum of care. The case manager will offer guidance. support, and coordination of the beneficiary's care as… more
- Public Consulting Group (Frankfort, KY)
- …www.publicconsultinggroup.com . PCG is currently seeking a qualified Registered Nurse to perform as a Case Manager . The Case Manager will be responsible ... publicly administered Medical Fund on behalf of a state agency. The Case Manager will be charged with helping program recipients, family members, and caretakers… more
- Sedgwick (Lexington, KY)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Field Case Manager -Sign On Bonus Eligible **This Field Case Manager ... Cincinnati, OH** **Must have as least 1.5 years of prior Field Case Manager workers compensation experience.** **PRIMARY PURPOSE OF THE ROLE:** Sedgwick Field … more
- CVS Health (Frankfort, KY)
- …members. **Key Responsibilities** + This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or ... within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical… more
- CVS Health (Frankfort, KY)
- …care for members. - This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or self-insured ... within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical… more
- CVS Health (Frankfort, KY)
- …all with heart, each and every day. **Position Summary** The High-Fidelity Wraparound (HFW) Case Manager (CM) is a person who safeguards that the principles of ... member outcomes and care planning components with appropriate engagement of clinical case management or crisis intervention as appropriate. - + Coordinates and… more
- Sedgwick (Frankfort, KY)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Telephonic Case Manager **PRIMARY PURPOSE OF THE ROLE:** While partnering with the ... injured worker, employer, and medical providers, create a case management strategy to facilitate medical recovery and a successful return to work through advocacy,… more
- Sedgwick (Frankfort, KY)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Field Case Manager -Sign On Bonus Eligible **We are growing all across the US ... and are looking for experienced Workers Comp Field Case Managers! Required to have a minimum of** **1.5...be considered.** **PRIMARY PURPOSE OF THE ROLE:** Sedgwick Field Case Managers work face to face with their injured… more
- Otsuka America Pharmaceutical Inc. (Frankfort, KY)
- The Patient Nurse Case Manager (PNCM) is a dynamic, field-based role that serves as a crucial educator for patients. This position helps to execute against a ... field + Background in advocacy, counseling, nursing, or social work + Case management experience in the specific therapy area + Bilingual skills, particularly… more
- Public Consulting Group (Frankfort, KY)
- …that is safe, timely, effective, efficient, equitable, and client-centered + Handles case assignments, draft service plans, review case progress and determine ... to conduct periodic in person assessments + Facilitates multiple care aspects ( case coordination, information sharing, etc.) + Helps patients make informed decisions… more
- Highmark Health (Frankfort, KY)
- …the appropriate clinical interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are enrolled in case ... management. The incumbent conducts outreach to members enrolled in case management including but is not limited to: developing a care plan, encouraging behavior… more
- CVS Health (Frankfort, KY)
- …comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan ... and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and regulatory standards while… more
- CVS Health (Frankfort, KY)
- …comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan ... intervention skills preferred Managed care/utilization review experience preferred. + Case management and discharge planning experience preferred. + Managed… more
- Cardinal Health (Frankfort, KY)
- …Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient markers of success. We're continuously ... integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the… more
- Cardinal Health (Frankfort, KY)
- …+ Manage the entire care process with a sense of urgency from benefit investigation/verification to medication delivery, ensuring an exceptional patient experience + ... Conduct benefit verifications and collaborate with various healthcare providers, including physicians, specialty pharmacies, and insurance companies, to ensure seamless coordination of patient care and timely access to necessary services + Assist in obtaining… more
- Molina Healthcare (Lexington, KY)
- …and have a current active unrestricted license in the state of KY Case Manager will work remotely supporting Medicaid Behavioral health population. Excellent ... level of the assigned members, particular state-specific regulations, or whether the Case Manager position is located within Molina's Central Programs unit.… more
- Travelers Insurance Company (Frankfort, KY)
- …with insured based on application of policy information to facts or allegations of each case . + Work with Manager on use of Claim Coverage Counsel as needed. ... as strategically appropriate. + Complete outside investigation as needed per case specifics. + Actively engage in the identification, selection and direction… more
- Molina Healthcare (Lexington, KY)
- …Nurse who lives in Kentucky and must be licensed for the state of Kentucky Case Manager RN will work with KY Medicaid population providing telephonic case ... behavioral health settings. Preferred License, Certification, Association Active, unrestricted Certified Case Manager (CCM) To all current Molina employees: If… more
- Molina Healthcare (Lexington, KY)
- …Reviews data to identify principal member needs and works under the direction of the Case Manager to implement care plan. + Schedules member visits with team ... **JOB DESCRIPTION** The Case Management Processor will be working 100% remote...environment (Must reside in the state of KY). Our Case Management Processor will be working with our MI… more
- CommonSpirit Health at Home (Lexington, KY)
- …to clinical protocols and guidelines. + Collaborate and coordinate with the RN Case Manager and other healthcare team members to ensure effective patient ... feelings of patients and their families. + Participate in case conferences and in-services or special case ...in case conferences and in-services or special case orientations. + Complete and submit all required documentation… more